The clinical study of laparoscopic radical nephrectomy combined with sunitinib for the treatment of locally advanced renal cell carcinoma

Abstract

Objective To evaluate the clinical efficacy of laparoscopic radical nephrectomy combined with sunitinib for the treatment of locally advanced renal cell carcinoma. Methods The clinical data of 47 cases of locally advanced renal cell carcinoma treated in our institute from January 2012 to January 2014 were analyzed retrospectively. All patients were treated by laparoscopic radical nephrectomy in the first place, in which 27 cases of patients treated by sunitinib and 20 cases of patients treated by IL-2 were divided into group A and group B. The operation time, blood loss, postoperative drainage time, postoperative gastrointestinal function recovery time, hospital time and pathological data were observed in all patients. Follow-up 13-46 months, the complete remission rate, progression-free survival (PFS) and other indicators of drug efficacy and adverse drug reactions were compared between the two groups. Results All the operations were completed uneventfully without conversions to open surgery and no severe complications occurred, of which 12 cases were performed concurrent ipsilateral adrenal gland resection. The operation time was (150.3 ± 25.4) min, blood loss was (280.6 ± 30.4) mL, postoperative drainage time was (7.2 ± 1.4) d, postoperative gastrointestinal function recovery time was (1.5 ± 0.4) d, hospital stay was (11.8 ± 1.7) d. No statistical differences were detected between the two groups in complete remission rate (81.5% vs. 75.0%, P>0.05). The PFS in group A were significantly longer than in group B[(16.7±5.1) months vs. (14.2±4.6) months] (P<0.05). The incidence of grade I adverse reactions in group A were significantly higher than in group B (66.7% vs. 25.0%, P<0.05). However, the incidence of grade II adverse reactions in group A were significantly lower than group B (25.9% vs. 65.0%, P<0.05). Conclusions The laparoscopic radical nephrectomy combined with sunitinib for the treatment of locally advanced renal cell carcinoma is safe and effective, which can effectively improve the prognosis of patients with locally advanced renal cell carcinoma, it is worthy of clinical application. Key words: Kidney Neoplasms; Nephrectomy; Protein-Tyrosine Kinases